Posts Tagged ‘FRAX’
Tomorrow I am at the 2014 National Osteoporosis Foundation meeting. Actually the name “National Prevent Fractures Organization” would better explain our goals. We don’t care about Osteoporosis as much as we care about Preventing Fractures.
DXA and T-score test results of “osteoporosis” only identify about 15% of the persons who will fracture. How can we identify those persons with “osteopenia” who will fracture? We use FRAX and Vertebral Fracture Assessment (VFA). My Poster # 18 tomorrow and Friday documents how adding VFA to DXA identifies additional persons at high risk for Fractures.
The International Society for Clinical Densitometry (ISCD) met last week. Our society has been dedicated to properly evaluating DXA to determine Bone Mineral Density (BMD) and t-score. Now ISCD is taking the next step.
The recurring theme at the 2014 ISCD joint meeting with the International Osteoporosis Foundation (IOF) was that DXA, BMD, and t-score are only tools to reach the real goal. The real goal is Preventing Fractures. DXA, BMD, and t-score alone do not get us to that goal. As health care providers, we can best prevent fractures by evaluating the reasons for Fracture Risk, and correcting those issues.
Several patients in the last month have decided not to take the “unnatural” risk of taking medication for their Postmenopausal Osteoporosis. They have been scared by the media emphasis on rare possible risks and side effects of taking osteoporosis medication. They are not aware of the much greater Natural Fracture Risk of being a Post-menopausal Woman.
One patient specifically cited the risk of OsteoNecrosis of the Jaw (ONJ) as her reason. Her risk of ONJ if she takes an Antiresorptive is less than 1 /10,000 per year. Her FRAX calculation shows a total fracture risk of 1/10 per year and hip fracture of 1/35 per year if she does not take medication. She is 1000 times more likely to fracture without medication as she is to have ONJ with medication. Natural Risk can be a Bummer!
DXA identifies only 15% of persons with increased Fracture Risk. Are you in the other 85%? To find out, you should get a Complete Bone Health Evaluation. And that is…….
First and foremost, it is an entire office visit devoted to bone health. That gives you and your doc enough time to fully discuss bone health issues. Next there is the full panel of tests: DXA, VFA, CBC, CMP, TSH, PTH, and 25-hydroxy Vit D level. Finally, there is FRAX.